Homestead_Tepovich..•^�3, CLAIM FOR AD PROPERTY TAX FORM YEAR
� �e- y' CREDIT/STANDARD DEDUCTION Hcio �
:' State Form 5473 (R2/t-90)
�'°�° � INSTRUCTIONS: See reverse side for �iling instructions. /
CERTIFICATION STATEMENT �/
(We) �, _ certify that on the 1 st day of March , 19
We) occupied as our principal place o residence t,�he �foll wing described real property for which a Homestead
�operty Tax Credit is hereby claimed: L�J I(We) owned ❑ Are buying under contract
n
County
Parcel N
interest in the entity that is liable for the property taxes on the property and that owns the
R1�it under a contract.
CONTRACT RECORDED
Simple Owner's Name
is recorded
PROPERTY DESCRIPTION
Legal Description
3•�-I I
town,
Number � Page
If any portion of ihe residential structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDEHiIAL
VALUE
Land not exceeding 7(one) acre immediately
surrounding residential improvements (�)
Otherland (2)
Total land - line (1) plus line (2) (3)
Residential improvements Dwelling (4)
Garage (5)
Oiher improvemenis (6)
Total improvements - line (4) through line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
1989 Pay 1990
Lesser of 1/2 Homestead
Valuation or $2,500
Signature of Auditor
STANDARD DEDUCTION ALLOWANCE
7990 Pay 1991
Lesser of 1/2 Homestead
Valuation or.$2,000
1991 Pay 7 992 19 — Pay 19 —
Lesser of 1/2 Homestead Lesser of 1/2 Homestead
Valualion or 51,500 Valuation or $7,500